Stephen Hume: Looking for a flu vaccine? Good luck

I chatted Sunday with a couple of 20-somethings about their journey through the flu-shot maze.

Here’s how it went:

First, when public health authorities began warning about the perils of swine flu, they listened. Like its famous but far more lethal predecessor from 1918, swine flu attacks groups outside the usual pattern.

Normally, flu is most dangerous to the very young and the very old, groups at the margins of a population and for whom immune systems have either not fully developed or have been weakened by age or some underlying condition. B.C. provides free flu shots to these risk groups.

The swine flu, however, most seriously affects people from what is normally the least-vulnerable population.

More than 80 per cent of cases of illness in B.C. right now are swine flu, and it has been hitting healthy people aged 20 to 65 the hardest. More than 60 per cent of cases are in this age bracket, with particular impacts on pregnant women and young adults.

As of Jan. 9, the B.C. Centre for Disease Control reported three suspected deaths and 40 admissions to intensive care units. In Alberta, the pattern is similar but more serious and widespread.

So public health authorities reasonably urged healthy young people to stop assuming they are immortal and go get vaccinated. Good plan. Enter the two university students with whom I talked.

They decided, given the seriousness of this season’s flu, the fact they were just returning to a crowded campus, and on the urging of public health authorities that they would do the responsible thing and get vaccinated.

Off they went to their local pharmacy, which displayed a large sign promoting vaccinations. It had no vaccine. They tried another pharmacy advertising “Flu Shots”. Nope. Their next stop was the pharmacy in a giant supermarket chain. No luck there, either.

Okay, off to the family doc.

Patient One in search of a flu shot: They’d make an appointment for next week. Come back then.

Patient Two (who cohabits with Patient One): Sorry, you are not officially a patient here, so we won’t vaccinate you. Try a pharmacy.

Patient One returned a week later: Sorry, under provincial rules, you are not designated as eligible for a free shot, and under the same rules we can’t administer one you pay for. To qualify for the free shot you have to be very young, over 65, pregnant, or have an existing risk condition like asthma.

Our two patients next try their university clinic. It has no vaccine and no idea when it will.

What next? Try the regional health authority. It publishes a list of pharmacies with vaccines. They are scattered all over town, but hey, it’s no longer hit or miss.

Oh yes, it is.

The next four pharmacies on the list have already exhausted supplies, and the public health clinic is restricting vaccinations to families, by appointment only, but there will be an open drop-in — in a couple of weeks. Oops, cancel that, now public clinics will vaccinate only those eligible for the free vaccine, which under provincial rules excludes anyone aged five to 65 who isn’t pregnant or doesn’t have another risk condition. All those young people should go to a pharmacy and pay for their shot.

Okay, but the next three pharmacies in a row have run out. Check back to the health authority list — it’s down to two places where shots are available.

We’re now 12 stops into the search for the flu shot that public health authorities are urging when a kindly pharmacist’s assistant takes pity on our young couple.

He tells them quietly that a sister outlet across town still has vaccine. He’s telling them because he thinks they are in the high-risk group for swine flu since they are neither very young nor over 65.

On stop 13, two weeks after they began this public health odyssey, they finally have their vaccinations.

Of course, it takes about two weeks for the vaccine to be fully effective. In the time it took our couple just to find a vaccination provider, they could have acquired immunity — as they responsibly tried to do — and contributed to collective community resistance. Instead, they have been vaccinated but remain vulnerable just as the season peaks.

Meanwhile, the health authority has now cancelled its public drop-in clinics because they only have enough vaccine left for those who have made prior appointments.

All of which leads to a few observations.

When you plan for emergencies, include logistics. Our public health authorities suspected swine flu would return. We had a nasty round with this strain in 2009. This is why it was included in this year’s vaccine and why B.C. bought 1.4 million doses.

Immunize BC is the marketing slogan. But on the ground there seems to have been no integrated and consistent delivery plan. Instead, it has been a haphazard, laissez-faire, devil-take-the-hindmost vaccine lottery that seems more likely to cause public anxiety than quell it.

If this is the response to a relatively mild outbreak of a nasty virus, what happens when we get a really serious pandemic of a truly lethal one?

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Stephen Hume: Looking for a flu vaccine? Good luck

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